{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:13:41Z","timestamp":1791465221663,"version":"4.3.4"},"reference-count":0,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2006,9,1]],"date-time":"2006-09-01T00:00:00Z","timestamp":1157068800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2006,9]]},"abstract":"<jats:p>\n                    The relative effects of risk factors on the prevalence of resistant pneumococcal clones are hard to determine.\nOur aim was to evaluate the effect of risk factors on the prevalence of resistant pneumococci in Iceland in\n2003 and compare these data with results of identical studies performed in 1993 and 1998. A randomized sample\nof 1,107 children was chosen from all 2,532 children 1 to 6 years old living in four communities. Pneumococci\nwere carried by 64% of the 824 children enrolled and 9.5% were penicillin nonsusceptible (PNSP),\nas opposed to 8.1% (1998) and 8.5% (1993), and multiresistant strains of serotype 6B were 2.5% compared\nto 7.5% and 7.7% (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001). Antimicrobial use had declined in 10 years from 1.5 to 1.0 courses\/child per\nyear. The only significant risk factor for carriage of PNSP and erythromycin-resistant pneumococci was antimicrobial\nconsumption. The multiresistant type 6B strains disappeared from the areas with the lowest antimicrobial\nuse but maintained unchanged prevalence in the area with the highest use. The number of erythromycin-\nresistant, penicillin-susceptible strains of all pneumococci (37\/475, 7.8%) increased significantly\nfrom the previous studies (7\/353, 2.0%, 1998, and 2\/390, 0.5%, 1993). This observation is associated with increased\nuse of macrolides, especially azithromycin, in one of the study areas. Spread of novel resistant clones\nappears to be the main reason for rapid and significant changes in pneumococcal resistance rates. The choice\nof antimicrobial class appears to influence the selective environment favoring particular resistant clones.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2006.12.169","type":"journal-article","created":{"date-parts":[[2006,9,26]],"date-time":"2006-09-26T10:30:33Z","timestamp":1159266633000},"page":"169-176","source":"Crossref","is-referenced-by-count":54,"title":["The Role of Antimicrobial Use in the Epidemiology of Resistant Pneumococci: A 10-Year Follow Up"],"prefix":"10.1177","volume":"12","author":[{"given":"Vilhjalmur A.","family":"Arason","sequence":"first","affiliation":[{"name":"Department of Family Medicine, University of Iceland, Solvangur, Hafnarfjordur, Iceland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann A.","family":"Sigurdsson","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Iceland, Solvangur, Hafnarfjordur, Iceland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helga","family":"Erlendsdottir","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Landspitali University Hospital, Reykjavik, Iceland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigurdur","family":"Gudmundsson","sequence":"additional","affiliation":[{"name":"Directorate of Public Health, Reykjavik, Iceland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl G.","family":"Kristinsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Landspitali University Hospital, Reykjavik, Iceland."},{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2006,9]]},"container-title":["Microbial Drug Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2006.12.169","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2006.12.169","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:23:29Z","timestamp":1777667009000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1089\/mdr.2006.12.169"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,9]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2006,9]]}},"alternative-id":["10.1089\/mdr.2006.12.169"],"URL":"https:\/\/doi.org\/10.1089\/mdr.2006.12.169","relation":{},"ISSN":["1076-6294","1931-8448"],"issn-type":[{"value":"1076-6294","type":"print"},{"value":"1931-8448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,9]]}}}